Peer Mentoring and Health Literacy: A Shift in Information Sharing

Leanne Peace, MSW, MHA, is director of the Missouri Kidney Program in Columbia, MO. Jaime A. Roy, MPA, is associated with the ESRD National Coordinating Center in Lake Success, NY.

In the ever-changing climate of health care, providers eagerly seek innovative approaches to actively engage patients and their families in their care. The Center for Advancing Health defines engagement as “actions individuals must take to obtain the greatest benefit from the health care services available to them.”

As providers, the next logical question is, how do we encourage individuals to take these actions toward engagement? Perhaps the question isn’t how but rather who does the encouraging? Many health care organizations have determined that the patient population contains infinite potential and resources that can be activated through peer mentoring programs.

Although approaches may vary, peer mentoring programs are generally designed to match a more experienced patient with an individual (a peer) who has a new diagnosis or faces challenges in dealing with a chronic condition. Peer mentors do not provide medical advice; rather, they serve as a companion who can share experiences and help legitimize and relieve feelings of fear, anger, grief, and anxiety. Most important, by positively modeling active engagement, peer mentors can provide hope and encouragement, aid in problem solving, promote self-care management, and reinforce communication between patients and their health care providers.

Mary Wu, a two-time kidney transplant recipient and patient advocate, responds: “Peer mentorship is an excellent means of providing [the] support [needed] to endure [the complexity of your] health journey… [it is] commendable that peer mentorship is coming into the forefront and playing an active role in the ever-changing health care system.”

The National Kidney Foundation of Michigan (NKFM) has successfully led an effective peer mentoring program since the 1980s and has trained more than 8000 chronic kidney disease (CKD) peer mentors. Erica Perry, MSW, has worked with NKFM since the inception of that organization’s peer mentoring program and has now retired. Perry says that peer mentoring gives patients an opportunity to learn in a safe and empowering environment where questions are encouraged and answers are explained in ways that are useful, practical, and without complex medical terminology.

The peer-to-peer learning environment in these programs can also provide a more holistic approach to ensuring health literacy. “Health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions and services needed to prevent or treat illness,” according to the US Department of Health and Human Services, Health Resources and Services Administration.

The vision of the NKFM peer mentoring program addresses the need for health literacy to play an integral role in a CKD patient’s life and the peer-to-mentor relationship. “As a valuable part of the health care team, peer mentors empower patients to move forward with their lives after being diagnosed with kidney disease. [Peer mentors] are a bridge for better communication with medical staff, which assures that staff understand patient concerns, issues, and priorities. Peer mentors show patients that controlling and managing their health will allow them to live longer, happier lives,” according to the NKFM.

Julia Herzog, MSW, a kidney transplant recipient, currently oversees the NKFM peer mentoring program. She explains that the NKFM peer mentoring program includes training in communication and teaches mentors to focus on important topics and to effectively communicate to peers what resources are available that can help them make health care decisions. This approach can have a meaningful impact on clinics that want to focus on important educational topics, such as treatment modality options, infection prevention, access options, self-care, and more, because patients tend to be more receptive to receiving information that comes from a peer.

Mentors are able to break down communication barriers by building trusting relationships with their peers. They can share experiences of overcoming concerns and are able to relate as empathetic and friendly helpers rather than medical experts. Mentors should be trained in how to empower their peers through information sharing and also how to strengthen communications between peers and their health care team for answers to any and all medical questions.

Individuals interested in becoming peer mentors with the NKFM peer mentoring program are screened to ensure that they exemplify the traits of good communicators and empathic listeners, valuing confidentiality and finding excitement in helping empower others. Additionally, peer mentors should be successful in modeling self-management, working with their health care team to make decisions, and having the time and energy for training, retraining, and visits with patients.

It is not uncommon for providers to express concerns regarding patient confidentiality and objectivity, becoming overinvolved, or giving erroneous medical information. These concerns may create barriers in the successful launch of a peer mentoring program. Intentional trainings that explain the role and boundaries of a peer mentor and the effective methods that can help providers and patients work together to improve the quality of life and care of individuals with CKD are key to effective peer mentoring programs.

Both Perry and Herzog indicate that training and frequent in-service programs for peer mentors are key to developing a successful program and earning the confidence of the health care providers who implement these programs. “It [peer mentorship] is a two-way street and an all-win situation!” said transplant recipient and patient advocate Mary Wu.